Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041
Uses For This Medication
- Temozolomide is used to treat adults with a type of brain tumor called anaplastic astrocytoma which has not responded to treatment with other chemotherapy medications.
- Temozolomide is also used in combination with radiation therapy to treat newly diagnosed adults with another type of brain tumor called glioblastoma multiforme. Following initial treatment with radiation therapy, temozolomide is then used as a maintenance treatment.
- Temozolomide is being studied for the treatment of other tumors, including melanoma and central nervous system lymphoma.
- This medication may also be given for other conditions as determined by your doctor.
How This Medication WorksTemozolomide is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow normally, which leads to tumor cell death. Benefits of This Medication In patients with anaplastic astrocytoma that has not responded to previous chemotherapy, clinical studies have shown that temozolomide can shrink these tumors. In patients with glioblastoma multiforme, clinical studies have shown that temozolomide can lengthen how long these patients live by several months.
Who Should Not Take This MedicationYou should not take this medication if you:
- Are allergic to temozolomide, any of its components, or if you are allergic to dacarbazine.
Precautions to be Aware of Before Taking This Medication
Blood related precautions
- This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises.Do not floss your teeth if you have been told your platelets are low.
- This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands well and often with soap and water, and brush and floss your teeth daily.
- Rarely, his medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
Gastrointestinal related precautionsThis medication may cause nausea and/or vomiting. Eat small frequent meals and bland foods (for example bananas, rice, apples, toast). If you are having moderate or severe vomiting, tell your doctor or healthcare provider. Nausea and vomiting can be treated with medications.
Organ related precautions
- This medication is broken down by enzymes (chemicals) in the liver and cleared from the body. In patients with severe liver disease, temozolomide may not break down normally which can lead to high levels of this medication in the body and a greater chance of side effects. If you have any liver problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
- This medication is cleared from the body by the kidneys. In patients with severe kidney problems, temozolomide may not be cleared from the body as well. This can lead to high levels of this medication in the body and a greater chance of side effects. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
Miscellaneous precautionsDo not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
Patient specific precautions
- It is not known if this medication is safe and effective in children under 3 years of age, however it has been shown to be safe in children aged 3 to 18 years with brain tumors.
- Older patients (more than 70 years of age) tend to experience more blood related side effects than younger patients, specifically a decrease in platelet levels and white blood cell levels.
- During the first cycle of treatment, women tend to experience more blood related side effects than men, specifically a decrease in platelet levels and white blood cell levels.
Pregnancy and Breastfeeding Precautions
- This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
- It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
- Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
Medication and Food InteractionsBefore using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with temozolomide and the following medication:
- Valproic acid
- All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
- You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
- Side effects can occur when temozolomide is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with temozolomide alone.
More common side effects
- Nausea, vomiting (see Precautions To Be Aware Of Before Taking This Medication)
- Tiredness (fatigue)
Less common side effects
- Decreased platelet and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
- Swelling in the ankles and legs
- Loss of appetite
- Hair loss
Rare side effectsThis is not a complete list of the rare side effects reported with temozolomide. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
- Back pain, muscle pain
- Decreased red blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
- Drowsiness, memory loss, difficulty sleeping, anxiety, depression
- Numbness and tingling in hands and/or feet from nerve irritation
- Stomach pain, loss of appetite
- Sore throat, cough
- Vision changes
- This medication is taken by mouth (orally) with a large glass of water one hour before a meal or at bedtime. This may greatly reduce the nausea and/or vomiting that can happen with temozolomide treatment. The capsules should not be opened or chewed. Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you. This medication can be given in different doses depending on your weight and the type of condition being treated.
- Temozolomide is usually taken once a day for five days. From Day 6 to Day 28, you will have a rest period and not take any temozolomide. Temozolomide is available in different strength capsules, and your daily dose may be made up of more than one capsule. Make sure that you understand exactly which capsules you are to take on the days of treatment.
- If you miss a dose of temozolomide, do not make up the missed dose by taking another. Check with your doctor or healthcare provider.
- It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
- Temozolomide capsules should not be opened. If the capsules are accidentally opened or damaged, be careful not to inhale or touch the contents to your skin.
- If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
- Store this medication at room temperature and keep in its original container.
- Keep this medication out of the reach of children or pets.
- Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.